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Brow Lift

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When the eyebrows are too low or too straight, they may give an old, tired, sad, or angry look to the face. Brow lift surgery is a procedure used to remove the wrinkles from the forehead and to enhance the position and arch of the eyebrows.

The Brow Lift Procedure

A forehead lift is performed in an outpatient medical facility, office surgical suite, or hospital. You should discuss the appropriate type of anesthesia with your doctor and the anesthesiologist. A forehead lift usually requires only local anesthesia (awake but sedated), though occasionally general anesthesia (asleep). Time in surgery is about one to two hours, and you return home the same day.

Brow lift may be performed through a conventional-incision method. Alternatively, your surgeon may use an endoscope tool that acts as a visual guide, which requires a smaller incision. The advantages of an endoscopic method can include a smaller incision, no general anesthesia, reduced bruising, quicker recovery time, and less scarring.

After a conventional forehead lift, you may experience

  • Temporary discomfort and numbness. This is managed with medication.
  • Headache. This can be a side effect from anesthesia
  • Swelling. This is managed with head elevation and typically subsides within a week.
  • Unusual sensations, which may include itching or lack of sensation at the incision line. This symptom normally disappears within six months.
  • Hair Loss. Regrowth usually occurs in one to three months.

Endoscopic Forehead Lift

For an endoscopic forehead lift, several tiny incisions are made within the scalp. The surgeon inserts the endoscopic instrument to produce a visual map of the inside of the forehead and eyebrows. The surgeon then inserts another instrument into the other incisions to lift the skin and to remove excess fat, muscle, or skin on the forehead and eyebrows. Temporary screws or sutures may be fastened to hold the position of the altered skin or muscle. The incision is stitched or clipped and gauzed. After surgery, a bandage is often wrapped around the head. Stitches and staples are removed within a week, and screws are removed in about two weeks.

After an endoscopic forehead lift, you may experience

  • Temporary discomfort and numbness. This is managed with medication.
  • Swelling. This is managed with head elevation and typically subsides within a few days.
  • Unusual sensations, which may include itching or lack of sensation. This is usually a minimal side effect that disappears in a short time.

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Brow Lift Complications And Risks

Complications are rare; however, there are risks associated with any medical procedure. Some patients may not be able to move their eyebrows or forehead. Additional surgery may correct this problem. Scar formation and permanent hair loss within the scar area may occur. Permanent lack of sensation at the incision line is also a rare complication. Infection, bleeding, and other minor complications are possible. According to the American Society for Aesthetic Plastic Surgery, endoscopic patients experience less frequent complications — reporting an incidence of less than 1 percent.

Preparing For Surgery

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Prior to surgery, you may be asked to:
  • Get lab testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking well in advance of surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:
  • What to do on the night before and morning of surgery
  • The use of anesthesia during your brow lift
  • Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. A brow lift may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

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What happens during brow lift surgery?

Step 1 - Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 - The incision

A brow lift may sometimes be performed using an endoscope (surgical video device) and special instruments placed through small incisions made within the hairline. This allows the tissue and muscle beneath the skin to be repositioned, altered or removed, correcting the source of visible creases and furrows in the forehead.

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Correction of a low-positioned or sagging brow may be made with or without the use of an endoscope through incisions at the temples and in the scalp.

This technique may be done in conjunction with incisions hidden within the natural crease of the upper eyelids to eliminate frown lines between the brows, on or above the bridge of the nose.

An alternative brow lift technique is the coronal brow lift. The coronal brow lift can pinpoint specific regions of the brow to correct.

This technique involves an incision from ear to ear, lifting the forehead and removing excess skin from the scalp.

Recovery time is often longer than the endoscopic brow lift due to the size of the incision.

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The incision lines from a brow lift are well concealed within the hair or natural contours of the face unless they are placed at the hairline to shorten the forehead.

Results appear gradually as swelling and bruising subside to reveal smoother forehead skin and a more youthful, restful appearance.

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Step 3 - Closing the incisions

Brow lift incisions typically are closed with:

  • Removable or absorbable sutures
  • Skin adhesives
  • Surgical tape
  • Special clips

Step 4 - See the results

Brow elevation may be maintained by the use of:
  • Permanent sutures
  • Small surgical screws
  • Absorbable fixation device placed inconspicuously at the temple

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My Recovery

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery?
    • When will they be removed?
  • Are stitches removed? When?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?

The risks include:

  • Unfavorable scarring
  • Bleeding (hematoma)
  • Infection
  • Poor wound healing
  • Anesthesia risks
  • Blood clots
  • Correctable hair loss at the incisions
  • Elevated hairline
  • Facial nerve injury with weakness or paralysis
  • Facial asymmetry
  • Skin loss
  • Numbness or other changes in skin sensation or intense itching
  • Changes in skin sensation
  • Eye irritation or dryness
  • Eyelid disorders that involve abnormal position of the upper eyelids (eyelid ptosis), loose eyelid skin, or abnormal laxness of the lower eyelid (ectropion) can coexist with sagging forehead and eyebrow structures; brow lift surgery will not correct these disorders; additional surgery may be required
  • Fluid accumulation
  • Pain, which may persist
  • Skin contour irregularities
  • Skin discoloration and swelling
  • Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
  • Possibility of revisional surgery

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